Key result
Systematic review protocol evaluates acute arterial stiffness changes from single haemodialysis sessions in ESRD.
Why the study?
Patients with end-stage renal disease face elevated cardiovascular risk linked to aortic stiffness, but little is known about the robustness of various arterial stiffness mechanical biomarkers following haemodynamic stress from a single haemodialysis session.
Does a single haemodialysis session change arterial stiffness indices in patients with end-stage renal disease?
Systematic Review
Does a single haemodialysis session change arterial stiffness indices in patients with end-stage renal disease?
This protocol outlines a systematic review to determine the acute effects of haemodialysis on vascular stiffness, which may help identify the optimal timing for cardiovascular risk assessment in this population.
Protocol for meta-analysis of haemodialysis effects on arterial stiffness in ESRD; leaves open optimal timing for cardiovascular risk assessment.
INTRODUCTION: Patients with end-stage renal disease are at higher risk of cardiovascular morbidity and mortality, a risk mediated in part by increased aortic stiffness. Arterial stiffness is assessed at different anatomical locations (central elastic or peripheral muscular arteries) using a variety of mechanical biomarkers. However, little is known on the robustness of each of these mechanical biomarkers following a haemodynamic stress caused by a single haemodialysis (HD) session. METHODS AND ANALYSIS: A systematic review has been designed and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. A targeted search strategy applicable in key databases (PubMed, Embase, the Cochrane Library, Web of Science and grey literature) is constructed to search articles and reviews from inception to 16 October 2020. Only articles of studies conducted with adults under chronic HD for kidney failure, with repeated measures of arterial stiffness metrics (pulse wave velocity, Augmentation Index, arterial distensibility or stiffness) following a before-and-after design surrounding a HD session will be selected. The screening process, data extraction and assessment of risk bias will be done by two independent pairs of reviewers. Meta-analysis will enable adjustments for potential confounders and subgroup analyses will be performed to discriminate changes in arterial stiffness metrics from elastic, muscular or global arterial territories. ETHICS AND DISSEMINATION: This study does not require ethical approval. Findings will be submitted for publication to relevant peer-reviewed journals and will be presented at profession-specific conferences. PROSPERO REGISTRATION NUMBER: CRD42020213946.
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Fortier et al. (2021) conducted a systematic review in End-stage renal disease. Single haemodialysis session vs. Baseline (before haemodialysis session) was evaluated on Change in arterial stiffness using PWV-based measurements. This systematic review protocol describes a planned meta-analysis to evaluate the acute effects of a single haemodialysis session on arterial stiffness in adults with end-stage renal disease.
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